Causes of Rosacea: Demodex Mites & Microbes. Demodex Mites. Demodex folliculorum Microscopic Demodex mites are a natural part of the human. In fact, dead human skin cells are the largest component of household dust and, just like dust mites, Demodex folliculorum may be part of a natural cleaning. Medical research has often pointed to the microscopic skin mite Demodex folliculorum as a potential factor in rosacea, specifically the bumps and pimples of.

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The objective of the study is to compare the frequency of Fooliculorum on the eyelash follicle of patients with rosacea and referents without rosacea or ophthalmological disorders. This is a comparative, open, observational, and cross-sectional study that included 41 patients diagnosed with rosacea and 41 referents without rosacea diagnosis or ophthalmic alterations. The individuals underwent a slit-lamp examination in which two eyelashes per eyelid were removed with fine forceps.

The presence of Demodex was sought by direct visualization under a light microscope. Chi-square test was used to compare the presence of mites in both groups. Eighty-two study individuals 45 females and 37 males were included, rosqcea which 41 patients follicuolrum diagnosed with rosacea and 41 were without rosacea or ophthalmic alterations.

The average mean age was 37 years with a minimum of 19 and a maximum of 87 years.

Demodex folliculorum |

Of the 41 patients with rosacea, 31 had erythematotelangiectatic rosacea and 10 had papulopustular rosacea. There were no patients with phymatous or ocular rosacea. The presence of Demodex was found in 32 patients: Rosacea was found to be a statistically significant risk factor for Demodex infestation in eyelashes, fo,liculorum of age and sex, with a higher prevalence in papulopustular variety.

The symptoms aggravate with an increase in their population. In ophthalmology, Demodex is thought to be an etiological factor in chronic blepharitis, conjunctival inflammation, and meibomian gland dysfunction. Furthermore, Demodex has also been reported to cause unusual ocular manifestations, such as superficial corneal neovascularization, marginal corneal infiltration, phlyctenule-like lesions, superficial corneal opacity, and nodular corneal scars, especially in patients with ocular rosacea.

The objective of the present study is to compare the frequency of Demodex in eyelash follicles in demorex with or without a clinical diagnosis of rosacea. A comparative, open, observational, transversal, and cross-sectional study was carried out in which 82 patients were included in the study. The first group consisted of 41 patients diagnosed with rosacea by the dermatology service, and the second group consisted of 41 referents without diagnosis of rosacea or ophthalmological complaints.

A total of eight eyelashes per eye were excised per patient, four eyelashes per eye. They were extracted with fine forceps and placed separately on each end of a slide.

A coverslip was placed on the top demoeex the eyelashes after coating them with immersion oil. Results were reported as positive presence of at least one Demodex in a tab or negative nonidentifiable.


Patients with Demodex were treated with selenium sulfide lotion mixed follicuoorum water on a concentration 1: It was found that shorter treatments had an increased risk of failure. Chi-square test was carried out, reporting a contingency table to analyze if a difference existed between the presence of Demodex and having rosacea or not.

A total of 82 folliculoeum were studied, of which 45 were women They were divided into two groups: In the group folliculprum patients with rosacea, 31 patients Demodex was present in 8 rosacew All patients underwent slit-lamp examination.

The findings for the first group rosacea were the following: For the second group no roxaceathree patients had thick meibomian secretion and two patients had scales on eyelashes and with telangiectasia. The distribution was demodwx follows: The average number of Demodex mites per patient was similar between groups 4 per patient.

There is a statistically significant association between Demodex density and rosacea. Forton and Seys inthrough a study of 49 patients with rosacea, evaluated biopsies of 1 cm 2 of skin showing an average mite density of The presence of Demodex was also demonstrated with facial pruritus with or without erythema.

There is currently no information linking rosacea and Demodex to eyelash follicles. Among our results, we obtained a frank predominance of this mite in patients with rosacea, which opens new doors on the intimate folliculorun that may exist between an external agent and the immune reaction in the pathophysiology of rosacea.

This finding supports the theory that this distribution is due to the fact that sebum acts as an energy source for Demodex. They performed skin surface biopsies in search of this mite. Their findings were similar to our study, and the average number of mites in the rosacea group was significantly higher.

The cheek was the area that showed the most infestation of the mite. Ten eyelashes per eye were extracted in both the groups, which were observed under a microscope. They found that the density of Demodex was greater in patients with chronic blepharitis than in controls 0. The Demodex count was significantly higher with facial rosacea.

A significant relationship was also found between facial rosacea and palpebral border inflammation. This suggests the likely relationship dmodex a high density of Demodex in rosettes of patients with rosacea and the development of corneal ulcers. Perhaps, a series of factors of these two pathogens initiates an inflammatory cascade triggering the characteristic changes of rosacea. This opens follicu,orum door to deeper studies as there is a symbiosis between both pathogens and exacerbates the inflammatory responses that produce chronic blepharitis.

There is a strong association between a higher concentration of the Demodex mite and the folliculogum diagnosis of rosacea. The role of this parasite in the pathophysiology of this disease as well as in its different subtypes has not been defined.

Demodex and rosacea: Is there a relationship?

In this protocol, the different subspecies of Demodex were not identified, which leads us to consider the possibility that there may be differences between them and their roles in the initial inflammatory reaction of rosacea. Folllculorum analysis opens the possibility of other folliculorum, such as therapeutic management for Demodex, treatment comparison at the ocular level, assessing whether treating Demodex infestation modifies rosacea disease course at both facial and ocular levels as well as its impact at the ocular level.


Rosacea proves to be a significant risk factor for Demodex infestation in the eyelashes. This is independent of age and sex and has a higher prevalence in the papulopustular variety.

It is acceptable to search for Demodex infestation in patients diagnosed with rosacea. Similarly, patients with chronic blepharitis may be questioned for common rosacea symptoms such as flushing and facial redness as the roxacea for Demodex in rosacea may improve their clinical presentation without necessarily being an ocular rosacea.

Identifying a higher folloculorum of Demodex in hair follicles of patients with rosacea could have therapeutic implications that would lead to improvement of the symptomatology and probably modification of the course of the disease.

National Center for Biotechnology InformationU. Journal List Indian J Ophthalmol v. Author information Article notes Copyright and License information Disclaimer.

Causes of Rosacea: Demodex Mites & Microbes

Received Jun 21; Accepted Sep Blepharitis, Demodex, frequency, rosacea. Methods A comparative, open, observational, transversal, and cross-sectional study was carried out in which 82 patients were included in the study.

Open in a separate window. Results A total of 82 individuals were studied, of which 45 were women Table 1 Distribution of Demodex.

Discussion There is a statistically significant association between Demodex density and rosacea. Conclusion Rosacea proves to be a significant risk factor for Demodex infestation in the eyelashes. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Demodex mites in human diseases. Biochem Lond ; Epidemiology and significance in daily dermatologic practice. J Am Acad Dermatol. Ocular surface discomfort and demodex: Effect of tea tree oil eyelid scrub in demodex blepharitis. J Korean Med Sci. The significance of demodex folliculorum density in rosacea. The relationship between demodex and ocular discomfort. Invest Ophthalmol Vis Sci.

Forton F, Seys B.

Density roeacea demodex folliculorum in rosacea: A case-control study using standardized skin-surface biopsy.

Chronic blepharitis caused by demodex folliculorum mites. Chronic blepharitis and demodex.

Demodex folliculorum: Causes, symptoms, and treatment

Arch Soc Esp Oftalmol. Correlation between ocular demodex infestation and serum immunoreactivity to bacillus proteins in patients with facial rosacea. Demodex-associated bacillus proteins induce an aberrant wound healing response in a corneal epithelial cell line: Possible implications for corneal ulcer formation in ocular rosacea.

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